May 2013 Bar Bulletin
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May 2013 Bar Bulletin

Bringing Mental Illness and Substance Abuse Out of the Shadows

By Pamela S. Hyde
Special to the Bar Bulletin


About half of Americans will meet the criteria for a mental disorder or substance use disorder in their lifetimes. And yet America is just beginning to acknowledge that behavioral health issues are common. They permeate our living rooms, break rooms, boardrooms, classrooms, emergency rooms, courtrooms and shelters in neighborhoods and communities across the country.

While many people do seek and receive help for their behavioral health issues, untreated mental illness is significant and takes a toll on our society. As a public health problem, behavioral health sits in the front row of economic burden - ahead of cancer and heart disease. For instance, serious mental illnesses cost the U.S. an estimated $193 million in lost earnings per year.

In addition, people with mental and substance use disorders have higher rates of heart disease, hypertension, diabetes and smoking than those without such conditions. The cost of treating these co-morbid health conditions is much greater when the underlying behavioral health issue is inadequately treated or goes untreated.

Untreated behavioral health conditions also can cost Americans their lives. People with mental and substance use disorders are nearly twice as likely as the general population to die prematurely, often from preventable or treatable causes. Each year, there are more deaths as a direct result of behavioral health conditions than as a result of HIV/AIDS, traffic accidents and breast cancer combined.

America loses about 100 people every 24 hours - not to war, acts of terrorism, natural disasters or widespread disease outbreaks, but to suicide. In 2010, more than 38,000 Americans committed suicide, about half of them from firearms. Among those ages 25-34, suicide was the second leading cause of death, ahead of homicide. In fact, in 2011 an estimated 8.5 million adults seriously considered suicide in the past year; 2.4 million made a plan; and 1.1 million attempted suicide.

Recent events such as the tragedies in Newtown, Aurora and Tucson remind us that waiting for behavioral health disorders to reach a crisis is neither a wise nor safe move, and it is almost never in the best interest of anyone. However, in the wake of the Newtown tragedy, it is important to note that behavioral health research and practice over the last 20 years reveal that most people who are violent do not have a mental disorder, and most people with a mental disorder are not violent.

Research shows that, on average, people with mental illness are no more likely to commit acts of violence than other similar individuals without mental illness. In fact, they are more likely to be victims than perpetrators of violence.

Only about 3 to 5 percent of violent acts can be attributed to persons with serious mental illness. And they are no more likely to involve guns than violent acts committed by people without mental illness. Factors contributing to or associated with persons with mental illness committing violent acts are the same as for others - age, gender, poverty status and life circumstances.

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